Summaries of health policy coverage from major news organizations

Lawmakers Seek To Reduce Costs of State Prison Health Care System

Lawmakers on Tuesday at a legislative hearing "demand[ed] immediate changes" to address health care spending within the state prison system, which has doubled to almost $1 billion since 1999, the Los Angeles Times reports (Halper, Los Angeles Times, 6/2). An April audit conducted by the Bureau of State Audits at the request of the Legislature's Joint Audit Committee found that during the last five years, 77% of prison contracts for health care services were awarded without competitive bidding, and contract costs increased by 150%. The audit also found that the Department of Corrections -- which runs 32 prisons with 160,000 inmates -- paid hospitals, laboratories and clinics $239 million for contracted services during fiscal year 2003-2004, compared with $96 million during FY 1998-1999. In addition, the report said that the prison system may be paying inappropriate and invalid medical claims (California Healthline, 4/7).

Indicative of Other Issues?

Some lawmakers on Tuesday said that "at the same time prisons are entering into contracts with private health care providers with no discernible cost controls, many prisoners are unable to get the most basic treatment," the Times reports. Sen. Jackie Speier (D-San Mateo) cited a report that last Thursday a male inmate underwent a breast reduction procedure, although the corrections department has had to end efforts to reduce tuberculosis infections (Los Angeles Times, 6/2). Legislators called the report "an example of a prison system that provides more lavish care for the incarcerated than is available to the general public," the San Jose Mercury News reports (Folmar, San Jose Mercury News, 6/2). Average health care costs per inmate currently exceed $5,500 annually, compared with less than $4,000 three years ago. Speier said that the corrections department "has got to stop hemorrhaging health care dollars," adding, "California inmates enjoy a better level of health care than millions of Californians" (Thompson, AP/San Francisco Chronicle, 6/2) Assembly member Rebecca Cohn (D-Campbell) said, "We need to protect the constitutional rights of the prisoners, but ... these guys are getting care that I don't even get." Assembly member Todd Spitzer (R-Orange) said that the corrections department should have developed a plan to address inmate health care spending because the audit was released two months ago, adding, "This is what people hate about government."

Department's Reaction

According to the Times, "[p]rison officials challenged some of the accusations made but acknowledged that reforms were needed" (Los Angeles Times, 6/2). Jeanne Woodford, director of the corrections department, said that providing adequate and cost-efficient medical services to a diverse inmate population with different health issues is one of the most difficult challenge she faces, adding, "I'm responsible for one of the largest managed health care systems in the nation" (AP/San Francisco Chronicle, 6/2). Woodford said, "We are using the recommendations contained in the Bureau of State Audit report as a blueprint for change," but she added that the department is "under court mandates affecting our services." Prison officials said they authorize only necessary surgeries and that uncommon procedures require approval by the corrections department and a team of physicians (Los Angeles Times, 6/2). In response to the report of the male breast reduction performed, corrections department spokesperson J.P. Tremblay said, "We don't know all of the facts of this case until the file is reviewed, but I can tell you from a procedural and policy standpoint, the department does not provide cosmetic surgery" (San Jose Mercury News, 6/2).

Transportation Costs

Legislators also said that the department needs to identify strategies to treat inmates at providers located closer to prisons (Los Angeles Times, 6/2). According to the AP/Chronicle, the department said that last year the state spent more than $10 million and this year will spend $8 million to transport prisoners because "not enough providers want to work in prisons or because nearby providers won't accept state rates." In response, Sen. Gloria Romero (D-Los Angeles) has introduced a bill that would require prisons to contract for medical services within their own regions (AP/San Francisco Chronicle, 6/2).

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